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Background: It seems that 14-25% of the women retain at least 5 kg weight from 6 to 12 months after delivery and gestational weight gain is the most important reason of weight retention. Thus, we assessed the effect of prenatal nutrition education program on the retained weights at 8, 26, and 52 weeks after delivery in primiparous women. Methods: This randomized controlled trial was implemented among 192 primiparous pregnant women in five hospitals, fifteen community health centers, and fifteen private offices. Self-developed questionnaire was used to collect the participants' characteristics. A 72-hr dietary recall was applied to evaluate the food intakes before and after intervention. The pregnancy physical activity questionnaire determined the physical activity score. The participants' weights at 8, 26, and 52 weeks after delivery were measured by a digital beam. Results: The means of postpartum weight decreased in both groups, but nutrition education was significantly effective on reducing postpartum weight in intervention group (ß = -3.112, SE = .7384, P < 0.001). Also, the women in intervention group had less retained weight compared to control during the follow-up (ß = -3.35, SE = 0.75, p < 0.001). The proportion of pregnant women in intervention group who reached to their pre-gravid weight was more than control during the follow-up (OR = 2.86, 95% CI: 1.62, 5.07). Conclusions: Nutrition education considering an individualized calorie-appropriate diet for each pregnant woman and based on the national guideline is effective on postpartum weight retention and reaching to pre-gravid weight. [ABSTRACT FROM AUTHOR]

Background: Some studies have shown that Socioeconomic Status (SES) is positively related to insulin resistance among different population groups, except for pregnant women. Therefore, we examined the relationship between SES and Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) index as well as mediating variables. Materials and Methods: This study was performed on 138 primiparous healthy women at 6-10 weeks of pregnancy. The association between SES and HOMA-IR was analyzed by regression analysis, and mediating variables were determined by mediation analysis. Results: SES score was positively correlated with HOMA-IR index [β = 0.02, t101 = 2.20, p = 0.03, 95% CI: (0.00-0.05]. The higher percentage of mediation was related to maternal weigh (70.80%). Job activity had a protective effect on the association between SES and HOMA-IR (-62.50%). The total percentage of two mediators was 25%. Conclusions: The positive relationship between SES and (HOMA-IR) in early pregnancy may provide a way to control this condition. [ABSTRACT FROM AUTHOR]

Hookah smoking is now a serious health threat especially for adolescents. Implementation of planned interventions can help reduce hookah smoking. This study was conducted to investigate the effect of a campaign Hookah is the Enemy of Health Campaign (HEHC) based on the protection motivation theory to prevent hookah smoking among the youth in Sirjan city, in 2018. This was a pre- and post-intervention study. Participants were 280 male and female youth who were selected randomly through the health centers of Sirjan. The educational campaign was conducted during 3 months and participants were trained through interpersonal, group, organizational and community channels and mass media. Data were collected by filling out a questionnaire (containing 64 questions) by the participant before the intervention and 3 months after. Data were analyzed by descriptive statistics (frequency and percentage), chi-square and Wilcoxon signed-rank test by SPSS20 software. The prevalence of hookah smoking was 44.3% in the target group. There was a significant change in the mean scores of knowledge and perceived susceptibility, perceived severity, response efficiency, self-efficacy, rewards, fear and protection motivation after the HEHC (p < 0.05), but there was no significant difference in the structure of perceived cost (p > 0.05). Also, the prevalence of hookah smoking among the target group for those who had ever consumed decreased from 8.9 to 4% and for those who used it occasionally decreased from 35 to 19.4%. The HEHC was effective in reducing hookah smoking, raising knowledge and improving the constructs of the protection motivation theory among the youth of Sirjan. [ABSTRACT FROM AUTHOR]

Objective: Menopause is a physiological occurrence characterized by a series of bothersome symptoms. Given that lifestyle affects people's health in general and many menopausal symptoms are influenced by changes in lifestyle, this study aimed to determine the relationship between lifestyle and severity of menopausal symptoms in women referred to health centers in Yazd city. Method: This cross-sectional study was performed using stratified random sampling where 343 postmenopausal women who had experienced natural menopause for 1-5 years, and did not have any chronic or debilitating disease were selected. The study was conducted in 2017 in Yazd city, Iran. The data collection tools were Walker's Health Promoting Lifestyle Profile II (HPLP2) and Menopause Rating Scale (MRS) questionnaires. A multiple hierarchical linear regression was used to investigate the association between lifestyle and severity of menopausal symptoms. Results: The total mean ± (SD) score of menopausal symptoms severity and women's lifestyle were 10.21 ± 6.55 and 126.44 ± 79.27, respectively. The results of multiple hierarchical linear regression showed a significantly negative association between lifestyle score and the mean score of menopausal symptoms severity in all three models (P-value <0.001). Conclusion: Our study concluded that healthier lifestyle reduces the severity of menopausal symptoms. These findings warrant that policy makers in the design of postmenopausal care plans and programs ought to pay special attention to the role of healthy lifestyles, including physical activity and healthy diet in enhancing menopausal symptoms. By preventing aggravation of menopausal symptoms; it is possible to economize on referrals to physicians and medicinal and therapeutic costs. Longitudinal and intervention studies with larger sample size may be required to confirm these findings. [ABSTRACT FROM AUTHOR]

Background and Aim: Despite the importance of breakfast, especially for students, unfortunately, this meal is usually ignored in daily routine. The aim of this study was to identify determinants among female high school students of Yazd province based on the Pender Health Promotion Model. Methods: This was a cross-sectional study conducted to examine 200 female high school students of Yazd, selected by cluster sampling method in 2016. A researcher-made questionnaire, based on Pender's Health Promotion Model, was used as a data collection tool. A panel of experts and Cronbach's alpha coefficient were used to confirm the questionnaire validity and reliability. In order to analyze descriptive data, SPSS version 22 was used. AMOS software (v.23) was employed for path analysis. Results: Direct impact of activity –related affect (0.300), interpersonal influences (0.276), and perceived barriers to eating breakfast (-0.223) were approved at significance level p<0.000. By influencing perceived barriers, perceived self-efficacy and previous related behavior indirectly affected breakfast consumption. These components determined 33% of breakfast consumption. Conclusion: By planning to create a positive feeling in students to have breakfast, to involve family and friends to encourage students to eat breakfast, to reduce barriers to have breakfast by increasing students’ self-efficacy, the behavior of having breakfast among students can be improved. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the ability of Iranian medical and dental students in thinking critically and to assess their ability in using definite components of critical thinking (CT). Methods: Multistage cluster sampling was utilized to recruit 125 preclinical (1st, 2nd and 3rd year of study) students in Yazd Shaheed Sadoughi University of Medical Sciences in Yazd, Iran. The Watson-Glaser Critical Thinking Appraisal (WGCTA) was applied to collect data. The statistical analysis of the data included One-way analysis of variance (ANOVA), t-test andbivariate correlations. Results: The mean total score for this sample was 45.33±5.4. Significant differences were found in total critical thinking score by gender (p = 0.022), residency (p = 0.026) and the year of education (p = 0.01). A significant correlation was found between the total CT score and the student's number of passed credits (r = 0.297, p = 0.003). Also, a significant difference was found in the students' scores on the WGCTA evaluation subtest by passing any research method courses (p = 0.04). Conclusion: The CT ability in medical and dental students in the present study was weak overall. Medical educators and clinical instructors should try to develop the ability of CT by teaching methods and techniques like purposeful planning and problem-based teaching to promote the components of CT in their students. The improving of CT in medical students has implications for medical education and promotion of medical profession. [ABSTRACT FROM AUTHOR]

Objective: Contact with second-hand cigarette smoke includes inhalation of cigarette smoke caused by the burning of the cigarette itself and inhalation of smoke exhaled by the smoker. Wife's pregnancy can be a motivating factor to change the behavior of men who smoke. Therefore, this study was conducted in order to determine the effect of training male smokers on the effects of secondhand smoke during pregnancy on their self-efficacy., Materials and Methods: The present study is an interventional type of pre-test and post-test. In this phase, random sampling was done from health centers in Isfahan, the participants were 140 smoking spouses of pregnant women, who referred to health centers to receive pregnancy care, and were divided into two intervention and control groups. The data collection tool was a researcher-made questionnaire on men's self-efficacy regarding second-hand cigarette smoke. The validity of the questionnaire was confirmed based on the opinion of the expert panel with content validity ratio (CVR)=0.87 and content validity index (CVI)=0.88, and its reliability was confirmed with Cronbach's alpha=0.97. All data were analyzed with SPSS18 software and Chi-score, Fisher, t-test., Results: There was no significant difference between the comparison of demographic variables in the intervention and control groups (p>0.05). The results of the paired t-test to compare before and after the training showed that the average score of self-efficacy (p<0.001) in the intervention group had increased significantly after the training, and according to the independent t-test, the average score of self-efficacy After training, it was more in the intervention group than the control group (p<0.05)., Conclusion: Men's self-efficacy regarding second-hand smoke increased after training, so the current training package is effective in training and can be suggested for future studies., Competing Interests: Conflict of Interests Authors declare no conflict of interests., (Copyright © 2023 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.)

Background: Follow-up studies have shown an increased risk of thyroid dysfunction in individuals with normal serum thyroid-stimulating hormone (TSH) levels. Furthermore, the possible consequences of minor differences in thyroid function (without achieving poor thyroid function) in the risk of weight gain during pregnancy are questionable, too. The production of TSH is under the hypothalamus-pituitary control, and food is one of the most effective environmental agents that control hypothalamic-pituitary-thyroid axis activity. Regarding the few available studies, we assessed the association of minor variations of TSH concentrations and nutritional status in the first trimester of pregnancy., Materials and Methods: This cross-sectional descriptive and analytical study was performed on 150 primiparous healthy women. Demographic and family characteristics were collected using a researcher-administered questionnaire. Nutrients intake were extracted from a 72-h recall, and physical activity scores were determined by the pregnancy physical activity scale., Results: The prepregnancy body mass index (BMI) (β =0.022, P = 0.004) and participants' weight at 6-10 weeks of gestation (β =0.006, P = 0.024) were positively associated with TSH concentrations, while total physical activity score was negatively correlated (β = ‒0.006, P = 0.047). We did not find any significant association between TSH values and energy-adjusted nutrients intake ( P > 0.05)., Conclusion: We suggest that differences in TSH concentrations within normal range in the first trimester are correlated with gaining weight, physical activity level, and prepregnancy BMI. TSH concentration and consequently thyroid function may influence on gestational weight gain or vice versa., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Research in Medical Sciences.)

Background: Today, marked by advanced scientific approach, urbanism, and changing life style, there is an ever-growing rate of fast-food consumption, which has significantly affected public health. Hence, the present research aimed to predict factors involved in fast-food consumption in light of the prototype/willingness model among the students of Rafsanjan University of Medical Sciences., Materials and Methods: In the present descriptive/analytical research conducted in 2018-2019, 350 students in Rafsanjan University of Medical Sciences were selected through proportionate stratified random sampling. The required data were collected using a self-administrated questionnaire in light of the constructs within the prototype/willingness model and fast-food consumption behavior. The data were analyzed in SPSS version 16.0 using descriptive and inferential statistics including mean scores, standard deviation, correlation coefficient, and linear regression., Results: Behavioral intention of fast-food consumption showed to be positively correlated with positive willingness, positive prototype, positive subjective norms, and positive attitude toward fast-food consumption. Furthermore, the correlation between positive behavioral intention of consuming fast food and positive subjective norms and positive attitude toward fast-food consumption was statistically significant ( P < 0.05). The underlying constructs of prototype/willingness model altogether managed to explain 13% of the total variance of fast-food consumption behavior. Behavioral intention showed to be the strongest predictor of the behavior (β = 1.613)., Conclusion: It is suggested that the preventive measures aimed to reduce fast-food consumption among the youth focus more on strengthening negative attitudes and subjective norms concerning fast-food consumption., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Education and Health Promotion.)

Background: Implementing a cervical cancer prevention program requires an exploration of certain behaviors concerning this disease. This study is aimed to evaluate the psychometrics of a questionnaire that enquired about the factors involved in Precaution Adoption Process Model (PAPM) for cervical cancer among suburban women in Bandar Abbas, south of Iran., Materials and Methods: The primary draft of the questionnaire was developed with a review of the related literature on cervical cancer and the constructs affecting PAPM, with 68 items. The face validity, content validity ratio (CVR), and content validity index (CVI) of the questionnaire were approved by a panel of 10 experts. The internal consistency and test-retest reliability of the questionnaire were estimated too. Field testing sample included 300 women recruited from a women's healthcare center in suburban areas of Bandar Abbas in the south of Iran. Exploratory factor analysis was used to evaluate validity, and Cronbach's alpha coefficient was estimated for reliability., Results: After the face validation, 11 items were eliminated. Once CVR was estimated, two items were discarded. The remaining items had a CVR >0.79. All had a CVI >0.79. Six items were eliminated in the factor analysis. The final questionnaire included 49 items organized in 8 factors including awareness, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, social norms, fear, and self-efficacy. Principal component analysis with varimax rotation indicated eight main components that explained 56.25% of the variance. Reliability assessment showed a good internal consistency for all subscales and the Cronbach's alpha score ranged between 0.82 and 0.90. The test-retest reliability showed that the correlation coefficients (between 0.81 and 0.89) were significant at the 0.01 level for all sub-scales., Conclusions: The final questionnaire was a new instrument comprised the effective constructs of PAPM and had a high reliability and validity. Thus, this questionnaire is recommended to be used to explore and enhance preventive behaviors of cervical cancer., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Education and Health Promotion.)

Introduction and Aim: Researchers and specialists believe that health maintenance and improvement through university students, as a part of society, play a crucial role in community configuration which should not be ignored. Since there was a few studies in these fields, researchers have sought to explore how mentioned workshops is related to cognitive emotion regulation, anxiety, depression, and sleep quality for the student volunteers of Shiraz University of Medical Sciences., Materials and Methods: In a randomized controlled trial, 152 students were allocated into the 3 equal groups (study1: "perseverance workshop" study2:"sleep and wakefulness workshop" and control group). Data collection instruments were the Granovsky cognitive emotion regulation scale, the Beck depression and anxiety inventories and Pittsburgh sleep Quality Index (PSQI-P) Questionnaire., Results: The results of comparing the anxiety and depression between groups showed that there was a decreasing and significant trend in the two intervention groups, before and after the two workshops ( P < 0.001). For PSQ analysis, within-group comparisons in those who have participated sleep and wakefulness workshop showed that the change trend was significant and in linear form. In addition, to compare those who have participated in perseverance workshop with the control group, there was a significant difference between the pretest and posttest results in the Cognitive Emotion Regulation subgroups., Conclusion: It can be said that the implementation of the workshops could improve the emotional state of the participants in comparison to the control group., Competing Interests: There are no conflicts of interest.

Introduction: Fetus health is of high importance in pregnant women and exposure to secondhand smoke (SHS) endangers maternal and fetal health. Therefore, in this study we examined the prevalence of exposure to SHS in pregnant women at home and the related factors., Methods: This cross-sectional study was conducted with 255 pregnant women who were referred to the Isfahan health care center from July to September 2018. A questionnaire that was designed by the research team was applied to collect data about the participants' prevalence of exposure, attitude-emotional dimension, perceived susceptibility, perceived severity, and perceived barriers. The questionnaire used was self-administered. The validity and reliability of the questionnaire were confirmed by a panel of experts. Cronbach's alpha of attitude-emotional dimension, perceived susceptibility, perceived severity, and perceived barriers were also calculated as 0.81, 0.91, 0.92, and 0.89, respectively. Statistically significant differences were examined using chi-squared test and Mann-Whitney test., Results: We found that the prevalence of exposure to SHS in pregnant women was 23.1%. The age of the husband (p=0.041), education level of the smoking husband (p=0.005), the education level of the pregnant woman (p=0.002), employment status of husband (p=0.010), and whether the pregnancy was planned (p=0.010) had significant association with the participant prevalence of exposure to SHS. Thus, older age of husbands, lower education levels of husbands and wives, unwanted pregnancies, and unemployment of husbands resulted in higher exposure to SHS. The mean scores of knowledge and perceptions were lower in women exposed to smoke than in non-exposed women (p<0.05)., Conclusions: The rate of SHS exposure was high in pregnant women. The knowledge and perception scores of exposed women to SHS were lower than those of non-exposed women. Low levels of education of husbands and women, unemployment and higher age of husbands, and unwanted pregnancies were considered as health risk factors. Therefore, effective training programs should be designed to educate pregnant women and their husbands., Competing Interests: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported., (© 2019 Mazloomy Mahmoodabad S. S.)

Introduction and Aim: The current study aimed at evaluating the effect of willpower workshop on anxiety, depression, and the Granovsky excitement components among the students of Shiraz University of Medical Sciences in the academic year 2016--2017., Materials and Methods: Students (140) were selected by the simple random sampling method and allocated into two equal groups of intervention (willing) and control, each of 52 individuals. Data collection instruments were the Garnefski cognitive emotion regulation scale and the Beck depression and anxiety inventories. The data were collected twice, before intervention and after the intervention (9 months after the study completion and holding the workshops). The control subjects received no intervention but were interviewed every 3 months., Results: The results of the current study indicated no significant differences in demographic variables and pretest scores between the groups, which indicate the homogeneity of the groups. In other words, there were no significant differences between the groups regarding demographic characteristics before the intervention ( P > 0.05). In addition, to compare the intervention and control groups, the Mann--Whitney U test was used and the results showed a significant difference in posttest results between the study groups ( P < 0.05). Also, there was a significant difference between the pretest and posttest results of each group ( P < 0.05)., Conclusion: Results of the current study indicated that training the stress, coping and willpower strengthening skills, based on the Granovsky excitement components, could promote psychophysical health and reduce anxiety and stress among the studied students., Competing Interests: There are no conflicts of interest.

Background: The living environment has an impact on the health of the elderly, and the safety of the house is one of the concerns of the elderly. Disregarding the safety concerns increases the falling., Aim: This research was conducted with the aim of influencing the living environment on falls among elderly people in Urmia city., Methods: This is a cross-sectional (descriptive-analytic) study which 200 elderly people were selected by random cluster sampling. Data were collected by using a two-part questionnaire including demographic information, and home safety assessment checklist. Data were analysed by using chi-square test and logistic regression in SPSS v. 21 software., Results: The incidence of falling in the elderly was 30%. There was a significant statistical association with age, sex, marital status and history of chronic disease. Results of logistic regression showed non-safe stairs (OR = 1.1, p = 0.002), unsafe toilet/bath (OR = 1.3, p = 0.001), unsafe bedrooms (OR = 1.7, p = 0.05) unsafe living room (OR = 1.4, p = 0.02) increase the falls in the elderly, as well as male gender (OR = 1.14, p < 0.001) and living with other people (OR = 0.19, p = 0.002) reduce the falls in the elderly., Conclusion: By identifying the risk factors of the physical space of the home, we can plan for implementing necessary interventions according to the risk factor or risk factors to prevent and reduce the falls in the elderly community.

Background: Given the increased rate of divorce, it is important to analyse the characteristics of divorce applicants. The theory of planned behaviour (TPB) can provide a suitable framework to predict, explain, and/or change the behaviours. In Iran, no instrument can be found, based on health education models, to investigate divorce petition filing as a behaviour., Aim: This study was conducted to design a questionnaire on withdrawal of divorce petition based on the TPB and estimate its validity and reliability., Material and Methods: A qualitative study was conducted in 27 participants involved in the divorce process using directed content analysis. The face and content validity of 58 items, drawn from the qualitative study, were evaluated by 10 experts. The reliability was estimated using Cronbach's alpha coefficient. The SPSS version 16 was used to analyse data., Results: Estimates of the face and content validity (quantitative and qualitative), revealed that of the 58 items, 48 were valid based on four of the constructs of the TPB. Cronbach's alpha coefficient was also derived greater than 0.6., Conclusion: The designed questionnaire, whose validity and reliability was confirmed in this study, can be used in similar studies. However, the social and cultural differences and their related effects should be considered.

Background: Physical activity (PA) prevents chronic diseases. Self-determination theory (SDT) provides a useful framework to understand the nature of motivational interviewing (MI)., Objective: This study aimed to determine the effect of MI-based intervention using SDT on the promotion of PA among women in reproductive age., Methods: Seventy women in reproductive age were selected by clustering sampling method for this randomized controlled trial. The questionnaire included the variables of physical fitness test, SDT, and global physical activity questionnaire (GPAQ). The validity of the questionnaires was approved using content validity ratio (CVR) and index (CVI). The reliability and internal consistency of the questionnaires and measures was approved using test-retest method and Cronbach's alpha test, respectively. The intervention group (n=35) received four MI sessions through theory and one standard education session about PA. The control group (n=35) received a standard education session about PA., Results: Four months after the intervention, an increase in the mean scores of total PA (p<0.001, ES=4.77), physical fitness tests including flexibility (p<0.001, ES=1.59), muscular endurance (p<0.001, ES=2.0), cardiorespiratory endurance (p<0.001, ES=0.51), and a decrease in mean scores of agility test (p<0.001, ES= - 0.51) and sedentary behavior (p<0.01, ES=- 0.74) was observed in the intervention group compared to the control group. The intervention group reported an increase in the scores of intrinsic motivation (p<0.001, ES=3.34), identified regulation (p<0.001, ES= 1.28), perceptions of competence (p<0.001, ES=0.81) and autonomy (p<0.001, ES=2.01), enjoyment (p<0.001, ES=0.98) and health motives (p<0.01, ES=0.19), health care climate (p<0.001, ES=4.6), and a decreased score of external regulation (p<0.01, ES=-0.55) and amotivation (p<0.01, ES= -0.56) over time, compared to the control group., Conclusion: MI-based intervention using SDT was effective on the promotion of PA., Trial Registration: The Trial was registered at the Iranian Registry of Clinical Trial (http://www.irct.ir) with the Irct ID: IRCT2015101924592N1., Competing Interests: Conflict of Interest: There is no conflict of interest to be declared.